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NHS patients' rights in Wales

This advice applies to Wales

About NHS patients' rights in Wales

As an NHS patient, you have rights that spread across your treatment, whichever service in the NHS you are using. This includes that you shouldn't be discriminated against, that your information should be kept confidential and rights about giving consent to treatment.

On this page you can find a wide range of information about your rights across NHS services. This includes:

You can also find more information about your treatment within the NHS on Adviceguide. This includes Using an NHS GP in Wales and Using NHS hospital services in Wales.

For more information, see Further help.

Discrimination in the NHS

Organisations and people providing health services are not allowed to discriminate against you because of your:

  • age
  • disability
  • gender reassignment
  • pregnancy and maternity
  • race
  • religion or belief
  • sex
  • sexual orientation.

If you’re treated unfairly when you receive health services because of who you are, it may be unlawful discrimination. If you’ve experienced unlawful discrimination, you may be able to do something about it.

Your rights to information

When you are using NHS services, the staff must explain things to you in a way that you can understand. If you have difficulties with communication the staff should put things in place you make sure you can understand. This might be, for example, by providing a language interpreter, a sign language interpreter or using an advocate.

If they don't do this, for example about your treatment, it might be that you have not given proper consent to treatment.

If a health care provider doesn't take steps to communicate with you properly, you might be able to complain that they have discriminated against you. It might be race discrimination if you can't understand what they are telling you because English isn't your first language. Or it might be disability discrimination if you can't understand what they are telling you because you have a disability. If you need to talk about something of a personal medical nature which affects only women or men and you need an interpreter, you can complain about sex discrimination if the interpreter is not the same sex as you.

For more information about making a complaint, see NHS Complaints.

Information about NHS services

As well as information about your treatment, you have a right to detailed information on local health services. This includes information on quality standards and maximum waiting times. You can get this information from a GP, Local Health Board or Community Health Council.

The NHS must not discriminate against you in the way it provides information about NHS services. For example, information must be available in formats which are accessible for disabled people.

The My Local Health Service website has information about the performance of health services in Wales. The information on the website mylocalhealthservice.wales.gov.uk includes:

  • hospital information, such as mortality rates, healthcare infection rates and nurse ratios
  • the results of patient satisfaction surveys
  • links to reports and locally-published performance data.

Your rights to see your medical records

You usually have the right to see most health records held about you. You are entitled to be told about how the records are used, who has access to them and how you can arrange to see them.

This information is provided in GP practices and Local Health Boards in the form of posters and leaflets. For more information about how to see your health records, ask the person in charge of treating you.

You also have the right to see a medical report written about you by a medical practitioner who has responsibility for your ongoing care. This might be, for example, your GP, consultant or any medical practitioner who has treated you in the past. For example, this might be a report your doctor has written for your employer or your insurance company.

Individual Health Records

The Individual Health Record (IHR) is being rolled out across Wales.

The IHR will provide information from GP practices to local emergency services. The information will include details of the patient's:

  • current medication
  • health conditions
  • allergies
  • immunisations
  • blood pressure
  • test results.

Only health professionals involved in the direct care of the patient will be able to access the information.

You will have to give your consent before a health professional can view your IHR. However, health professionals will be able to view your IHR if you are not capable of giving consent.

You will receive a leaflet about the IHR at least six weeks before the IHR is introduced in your area. It gives information on how to opt-out from the scheme. You will also be able to request a copy of the information on your IHR, but you may have to pay a fee.

You can find more information about IHRs on the NHS Wales website at: www.wales.nhs.uk.

You have to give your consent before any doctor or healthcare practitioner can examine you or give you treatment.

However, there are some situations when you can be examined or treated without your consent. These include if:

  • you have a notifiable disease or you are a carrier of a notifiable disease. A notifiable disease is a disease that the health care practitioner has to tell the local authority about
  • you have been detained under the Mental Health Act, in certain circumstances
  • your life is in danger, you are unconscious and you can't explain what you want.

Sometimes NHS staff will ask you to sign a form saying that you consent to treatment. This is called giving written consent. Other times, you can just tell the staff that you consent to treatment.

You will usually be asked for written consent for:

  • treatment which has a serious risk or side effects
  • general anaesthetic
  • surgery
  • some forms of drug therapy.

Your consent should be recorded in your notes with information about what the health professional has explained to you. This should happen whether you give your consent in writing or any other way.

Before you give your consent, the doctor must tell you about what the treatment is, what might happen because of it and if there are any serious risks. If you have not been given this information, your consent might not be valid, even if you have signed a form.

Also, if you give your consent for one type of treatment, this doesn't mean that you give your consent for further treatment. You should be asked again for your consent for further treatment.

Right to refuse NHS treatment

You have the right to refuse any physical intervention from NHS staff. This can include operations and injections, or help with getting dressed. When you visit a doctor, this is usually taken to mean that you consent to examination and treatment. However, the doctor can't act against your specific instructions, so you should tell the doctor about any treatment you don't want.

If there are a number of different treatments which can be used to treat your condition, you should be given information about these. However, you can't insist on a particular treatment if the doctor or consultant thinks this is not appropriate.

You may want to think about what you would want to happen if you became too ill to give consent to medical treatment. You could consider giving someone the power to make decisions for you. This is called a Lasting Power of Attorney for health and personal welfare. You could also consider setting out in writing what you want. This is called making an advance statement or an advance decision (also known as an advance directive or living will).  

You can decide that you would not want life-sustaining treatment but this decision would only be legally binding on health care professionals if the decision meets certain legal requirements.

You can find more information about a Lasting Power of Attorney, and advance statements or advance decisions on the Age Cymru website at www.ageuk.org.uk.

More information about Lasting power of attorney

If you are thinking of making an advance decision you should consult an experienced adviser, for example, a solicitor or an adviser at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email, click on nearest CAB.

Forcing treatment on you against your will is assault. If you are assaulted, you should contact your Local Health Board or Community Health Council to make a complaint. You may also wish to involve the police.

You can find out more information about the Community Health Council, including how to contact them, on their website at: www.communityhealthcouncils.org.uk.

For more information about making a complaint, see NHS Complaints.

In general, you have to give your consent for a doctor to carry out research on you.

You should be told about the procedures, and any risks there are. You should also be told that you can pull out of the research at any time. Your right to confidentiality should always be protected in research.

People who lack mental capacity, that is, people who can't make decisions for themselves, can also be involved in research. However there are strict rules about this, and measures have to be in place to make sure that people are safe and information is confidential.

For more information about mental capacity, see Managing affairs for someone else in Wales.

You have the right to refuse to take part in teaching without your treatment being affected. If you do not want to be involved in teaching, it's a good idea to let the hospital know in advance.

In Wales, anyone over 18 years old is assumed to be an adult who is able to give consent to or refuse treatment. This is unless there are other factors that mean they are not able to make their own decisions.

Young people aged 16 or 17 can also give consent to their own treatment. A parent or guardian doesn't have to give consent as well. However, even if the young person doesn't want treatment, a court can order that treatment is carried out. This might be, for example, if the treatment was thought to be in their best interests. If the young person is not able to give their own consent, for example if they lack capacity, a parent or guardian has to give their consent for treatment.

NHS staff also have a duty of confidentiality to young people aged 16 or 17, and shouldn't give information to the young person's parent or guardian without their consent.

Children under 16 can give their own consent to treatment provided they are judged capable of understanding what is involved by a doctor or Local Health Board. There is no general test for deciding this, it will depend on each situation.

If a child under 16 does not have enough understanding, consent is needed from a parent or guardian, or through a court order, unless it is an emergency. If a child under 16 who does have enough understanding refuses treatment, treatment can still be given with their parent’s or guardian’s consent or by a court order.

Young people or children under 18 can't give their own consent to experimental operations and blood donations, unless they have enough understanding of what is involved.

If the child is a ward of court, the court will decide whether the treatment is in the child's best interests. If a child is a ward of court this means that the court has the power to make all the decisions about the child that would usually be made by parents or guardians, until the order allowing this is changed. This is different from a court order for a specific treatment. However, if your treatment has been allowed by the court, you should have a chance to defend in court why you don't want treatment.

If the consent is about research and involves a child under 16, a parent or court can consent on their behalf.

You refuse treatment for your child

If you, a guardian or child refuse to give consent for treatment which a doctor thinks is necessary, the doctor is still obliged to treat the child. The action the doctor takes will depend on how urgently the treatment is needed.

When a child’s life is in danger, the doctor has the right to do whatever is needed to save the child’s life. If you or a guardian either fail to provide medical help for a child, or unreasonably refuse to allow treatment, you can be prosecuted for neglect.

Treatment abroad

People who live in Wales may, in certain circumstances, have the right to seek treatment in another European Economic (EEA) country, funded by the NHS.

If you're thinking about having medical treatment abroad, it's important to understand how it works and the risks involved. If you don't follow the correct procedures, you may end up being responsible for the full cost of treatment.

Information about treatment in the EEA is available on the NHS Direct wales website at www.nhsdirect.wales.

Paying for treatment not available on the NHS

For certain illnesses there are sometimes additional treatments for that you can't get through the NHS. For example, the treatment you are getting on the NHS for some types of cancer might not include some additional drugs because they are too expensive for the NHS.

In Wales, each Local Health Board makes their own rules about whether you can pay for these drugs yourself and still get care from the NHS.

If you think that you might want to pay for additional treatment yourself, this might affect your right to NHS care. You should check with your hospital before you begin to pay for any additional treatment or private care.

Right to die

The law about whether a person has the right to die is not clear. You have a right to refuse or stop treatment at any time, even if this means that you may die. However, a doctor can't either give you treatment, or not give you treatment, with the aim of bringing about or speeding up death.

If you are concerned about being treated against your wishes, you should ensure you make this clear at the time the treatment is proposed.

You may want to think about what you would want to happen if you became too ill to give consent to medical treatment. You could consider giving someone the power to make decisions for you. This is called a Lasting Power of Attorney for health and personal welfare. You could also consider setting out in writing what you want. This is called making an advance statement or an advance decision (also known as an advance directive or living will).

You can decide that you would not want life-sustaining treatment but this decision would only be legally binding on health care professionals if the decision meets certain legal requirements.

You can find more information about a Lasting Power of Attorney, and advance statements or advance decisions on the Age Cymru website at www.ageuk.org.uk.

More information about Lasting power of attorney

If you are thinking of making an advance decision you should consult an experienced adviser, for example, a solicitor or an adviser at a Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by email, click on nearest CAB.

Removal of organs after death

Unless you have said you do not want parts of your body used for research or donated to others after your death, whoever is legally responsible for your body can allow organs to be donated. This will usually be your personal representative. Before organs can be removed, medical staff must be certain that brain death has taken place, and a death certificate must be issued.

Further help

On Adviceguide

For more information on your rights and your GP in Wales, see Using an NHS GP in Wales.

For more information on your rights and your NHS hospital care in Wales, see Using NHS hospital services in Wales.

For more information about the healthcare available to you on the NHS, see What health care can I get on the NHS.

For more information about making a complaint about NHS care, see NHS complaints.

On NHS Direct Wales

You can find more information about NHS services in Wales on NHS Direct Wales at: www.nhsdirect.wales.nhs.uk.

The website gives you information about:

  • local medical services, including how to find your nearest dentist, GP, hospital or pharmacist
  • how to choose the best hospital or clinic for a particular treatment or procedure
  • common diseases and conditions such as diabetes, and guides to common procedures, such as hip replacements
  • how to make a complaint about an NHS service
  • how to lead a healthier life.

NHS Direct Wales also operate a non-emergency online enquiry service. Don’t use this service if you or someone else are feeling ill or experiencing symptoms – contact NHS Direct Wales or your GP. You can use the online enquiry service for questions about health. You can go online, enter your enquiry, and a skilled health information specialist will try to answer within 2 working days. They can answer enquiries about things like:

  • common conditions
  • local NHS services
  • patients' rights
  • healthy living.

The service is available in Welsh and English online at: www.nhsdirect.wales.nhs.uk.

You can also get confidential advice and information about health problems and services over the phone from NHS Direct Wales. It provides 24-hour access to free health advice from experienced nurses. The line is intended to help you care for yourself by advising on the next course of action, for example, whether to stay at home and what self-treatment to take, whether to visit a GP or a hospital.

The contact details for NHS Direct Wales are:

Telephone: 0845 46 47 (all calls charged at local rate)
Textphone on 0845 606 4647 or call through RNID Typetalk on 1 8001 0845 46 47
Website: www.nhsdirect.wales.nhs.uk

Local and national government information

The Welsh Government's Department of Health and Social Services is responsible for health services in Wales. You can find information about services and the latest health news and publications on the department’s website at: http://new.wales.gov.uk.

Local Health Boards (LHB) are now responsible for all health care services in their area. You can find out how to contact your LHB on the NHS Health in Wales website at: www.wales.nhs.uk.

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